54.80.29.182
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>12000</MaximumLimit>
  <StartDate>04/11/2014</StartDate>
  <EndDate>04/16/2014</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Martha</Firstname>
    <Middlename/>
    <Lastname>Sud</Lastname>
    <Age>90</Age>
    <Dob>07/21/1923</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/11/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>32 RIDELLE AVENUE</Address1>
      <Address2></Address2>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>TORONTO</City>
      <Postcode>M6B1H6</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>memaire@hotmail.com</Email>
    <Phone>
      <Home>4168209000</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName></AdDBeneficiaryName>
    <AdDBeneficiaryRelationship></AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4520710001268850</CreditcardNumber>
      <NameonCreditcard>Elliott Sud</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2014</CreditcardExpirationYear>
      <CreditcardAmount>85.38</CreditcardAmount>
      <CreditcardCodeNumber>509</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
e9af9251
ARS-02-0015926
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0015926</PolicyNumber><UserName>e9af9251</UserName><Password>e9af9251</Password></PolicyDetails></RegistrationRes>